By Kristian Jaime
With a vote to pass a “skinny” repeal of the Affordable Care Act (ACA) unsuccessfully attempted by the Republican-controlled Senate, the universal healthcare quagmire continues.
To date, the Congressional Budget Office (CBO) cited an estimated 24 million individuals potentially losing health coverage by a complete repeal and replacement of the ACA. To take its place was the American Healthcare Act (AHCA) proposed by Majority Leader Sen. Mitch McConnell (R-KY) and Speaker of the House Rep. Paul Ryan (R-WI).
While subsequent repeal efforts have failed to gain traction, a “skinny” repeal would do away with only some of the law’s less popular provisions such as the individual and employer tax penalty for not having or sponsoring an active policy. Yet even that drew ire from the CBO as Congressional math noted an estimated 15 million could stand to lose their coverage with the dialed-back strategy.
In response, advocacy groups such as San Antonio’s Healthcare NOW recently announced a rally that will take place Saturday, July 29 at 10 am at the Hemisfair pavilion. The rally will end with the community screening of “Fix it: Healthcare at the Tipping Point,” a documentary created by Richard Master, founder and owner of MCS Industries.
“We know that 60 percent of all the bankruptcies in the U.S. are because of medical debt,” said Sofia Sepulveda, Healthcare NOW-San Antonio co-chair. “When we know that 40 percent of the debt of the U.S. could be prevented if people had access to better healthcare, this is the time to demand and enact a medical system for us all.”
Their solution looks to the Canadian style of healthcare with a fully subsidized medicare policy for everyone structured as a single-payer system. With the federal government moving away from a for-profit model, skyrocketing administrative costs would be capped with those funds being funneled back to patient-centered care. The types of policies available to the public would still be varied as they currently are.
The plan also expands financial coverage for all medically necessary services as well as controlling costs through global budgets for hospitals, negotiated fees with physicians and bulk purchasing of pharmaceuticals. This ends investor ownership of healthcare delivery facilities.
According to the Henry J. Kaiser Family Foundation, 28 million Americans are still without insurance with another 32 million still underinsured. Those numbers, Sepulveda argued, would be considerably lower if the cost of medical care was not contingent on corporate profit margins but on collective bargaining from all key players in the medical industry.
“California had a study that if they passed medicare for all, they would have saved $32 billion a year, that is just one state alone. This is about all of us and needing to demand a system that will not put us in bankruptcy, we must persist and demand [improvements],” continued Sepulveda.
As the outcry coming from non-government organizations grows louder, so does the support for a single-payer system by physicians and other medical professionals. That has led to legislative action on their part that has largely fallen on deaf ears.
Physicians for a National Health Program (PNHP) has been behind the introduction of HR 676 every year since 2003, creating a Medicare for all system similar to Canada. While the bill was introduced by Representative John Conyers (MI-13), it was simply referred back to a subcommittee.
“America is the only country in the world that allows the private for-profit insurance industry to exist the way it does,” said Dr. Byron Tucker, M.D., a member of the PNHP. “Essentially their middleman takes in money and makes profit to withhold the premiums and not pass it to providers. Other countries in the world have figured out its not a productive use of tax payers money because it’s not providing healthcare.”
Many argue a larger insurance pool has more inherent benefits as it allows for more efficient price control. Under the current proposal by the revised AHCA, the potentially shrinking number of insured individuals only saves money in the short term as tax cuts for those earning $200,000 or more begin to undo the law’s long-term financial viability.
For Dr. Trucker, any proposal that starts with cutting the number of insured individuals in any pool could be nothing short of a death sentence for some.
Amy Vilela, a member of Healthcare NOW and Democratic candidate for Nevada’s Fourth Congressional District, echoed his sentiments. Vilela lost her daughter as a result of a blood clot, an easily treatable prognosis, due to lack of insurance. With an estimated 44,000 people dying every year from lack of health coverage, the fight for truly universal healthcare became personal.
“It’s one of the most important fights we have in America and it’s about life and death,” continued Vilela. “We’re all one circumstance away from a catastrophe like losing our insurance or a job. Even when we’re doing the right things, we’re still vulnerable to the for-profit healthcare industry.”
According to Vilela, the fight to pass a version of so-called “Trump Care” is one battle of a long war. Citing the increased participation of grassroots efforts to sway current leadership in Washington D.C., the former CFO turned candidate is confident the facts about the current proposal are out much to the dismay of the American public.
Healthcare NOW estimates that a move to a not-for-profit healthcare system with both capped administrative costs and collectively negotiated budgets across the board could save $400 billion nationally. Yet detractors routinely posit that leaving the administration of such sweeping legislation is best left to states and the private insurance industry.
“Repealing is not an option. Even though the ACA is not the optimum answer, morally we cannot see more millions of people without [coverage],” Vilela said. “Our legislators have to move forward to a plan like Medicare for all so that all people are covered. Right now, our government is paying for some form of universal healthcare anyway.”
In the days to come, the Senate will go back to the drawing board to craft a healthcare bill that can actually pass and be open to amendments. Till then, there is no lack of opinions or pressure to address the healthcare quandary.